Individual
DR. DOUGLAS KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2784
CO
152W00000X
Optometrist
CA12426T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79138276
—
CO
Enumeration date
11/01/2006
Last updated
04/17/2013
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